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Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 2 of 40

21.

An OTA assesses the vitals of her 80-year-old patient and finds that one of her vital signs is abnormal. Which of the following values is outside normal parameters?

  • Respiratory rate of 24 breaths per minute

  • Heart rate of 98 beats per minute

  • Blood pressure of 110/70 mm Hg

  • Oxygen saturation of 90%

Correct answer: Respiratory rate of 24 breaths per minute

Normal respiratory rate is 12 to 20 breaths per minute in an adult. A respiratory rate of 24 breaths per minute is abnormal. 

The other values are within the normal ranges. Blood pressure is normal below 120/80 mm Hg, heart rate is normal between 60 and 100 beats per minute, and oxygen saturation should remain between 80 and 100% (though it is ideal if it is as close to 100% as possible).

22.

What cognitive-perceptual intervention approach involves giving standardized cues to determine the effect they have on someone's performance?

  • Information-processing approach

  • Dynamic interactional approach

  • Compensatory approach

Correct answer: Information-processing approach

The information-processing approach involves giving the patient information about how they should approach the task, so standardized cues are a key part of this. 

The dynamic interactional approach emphasizes a person's ability to transfer information from one situation to the next to improve their function. The compensatory approach involves modification and repetition of certain strategies to improve performance.

23.

During intervention for cardiac rehab, the heart rate is regularly monitored. The patient has a lot of sensitivity in the upper extremities, so the OTA chooses to palpate a spot on the lower body to record the pulse. 

What site can the OTA use?

  • Popliteal

  • Brachial

  • Temporal 

  • Radial

Correct answer: Popliteal

A popliteal pulse can be palpated and monitored in the part of the leg just behind the knee.

A brachial pulse is palpated via the brachial artery above the anterior elbow. A temporal pulse is palpated on the face, between the ear and eye. A radial pulse is palpated on the radial side of the wrist, below the thumb.

24.

Which is NOT a good strategy to improve stair safety in the home?

  • Keep a shoe bin at the bottom stair to collect shoes off the living room walkway

  • Place handrails on both sides of the stairs

  • Place a light switch at both the top and bottom of the stairs

  • Remove carpeting from stairs

Correct answer: Keep a shoe bin at the bottom stair to collect shoes off the living room walkway 

In order to maintain safety at home, it is important to keep stairways clear. Although a shoe bin at the base of the stairs would help keep shoes out of the walkway on the main level, it would pose a tripping hazard on the stairs. A shoe bin may be useful if kept out of the way, not on the stairs.

The other strategies are good ways to keep oneself safe when negotiating stairs.

25.

What age-related changes might an OTA expect to see in an evaluation?

Select the three BEST responses.

  • Slight changes in muscle mass

  • Decreased endurance

  • Postural changes

  • Lower bone mass and density

  • Flattened intervertebral discs

  • Lower cerebral blood flow

Changes in muscle mass, lower endurance, and postural changes are all normal parts of aging that will be seen and accounted for during an OT evaluation. 

While adults do naturally experience lower bone mass and density, flattened spinal discs, and lower cerebral blood flow with age, this is not something that an OTA will see (or assess) during their evaluation.

26.

Which of the following is NOT the responsibility of a therapist planning a group?

  • Committing to being the only one who runs the group

  • Gathering materials

  • Designing activities

  • Providing a safe environment

Correct answer: Committing to being the only one who runs the group

Therapists may plan a group in advance and then take time off, leave their job, switch roles, etc. Someone else should be able to easily use their plan as their own, so it won't always stay with the therapist that created it. 

Gathering materials, designing activities, and providing a safe environment are all responsibilities of someone planning a group.

27.

The suffix "-itis" indicates inflammation. Which term describes a condition of inflammation of the bladder?

  • Cystitis

  • Dermatitis

  • Nephritis

  • Colitis

Correct answer: Cystitis

Cyst- refers to the bladder (or, more generally, a sac) and -itis refers to inflammation. In this instance, cystitis refers to inflammation of the urinary bladder.

Derm- means "skin" and dermatitis indicates a condition of inflammation of the skin.

Nephr- means "kidney" and nephritis indicates a condition of inflammation of the kidney.

Colitis refers to inflammation of the lining of the colon.

28.

What type of wheelchair should a therapist recommend to a patient who has right-sided paresis after a CVA?

  • Hemi-chair

  • Bariatric wheelchair

  • Tilt-in-space wheelchair

  • Manual wheelchair

Correct answer: Hemi-chair

A hemi-chair is designed to allow an individual with hemiparesis to independently propel it.

A bariatric wheelchair has a heavy-duty and extra-wide frame and is intended for patients with obesity. This chair has the axle placed further forward to prevent tipping due to greater weight displacement in front of an individual, as well as to allow for easier self-propulsion.

A tilt-in-space wheelchair assists with pressure relief when a patient is unable to independently do so with positioning or weight shifts. It can also be used for individuals who have severe extensor posturing that limits their ability to remain seated in a manual or typical power chair. With the tilt-in-space chair, the seat and back tilt backward as a unit.

A manual wheelchair requires the user to use both hands to propel, push, turn, and navigate the wheelchair.

29.

What major factor should a COTA consider when selecting assistive technology for a patient?

  • Social acceptance

  • Style

  • Temperature

  • Frequency of use

Correct answer: Social acceptance

Patients should be able to use their assistive device without it impacting their social function. Their device should remove social barriers for the patient and make their participation in this and other occupations easier.

The style of an assistive device may be a personal preference, but it's not a major factor in device selection. Temperature is not a factor related to assistive devices. Frequency of use should not impact assistive device selection, as technology should be streamlined and simple to use, regardless of how often someone needs to rely on it.

30.

Margaret Rood proposed four sequential phases of motor control, including reciprocal inhibition, co-contraction, heavy work, and skill. Which movement phase describes maintaining 45 degrees of shoulder flexion while performing a fine motor task?

  • Skill

  • Heavy work

  • Co-contraction

  • Reciprocal inhibition

Correct answer: Skill

Skill is the highest phase of motor control and involves complex distal movement coupled with stability of proximal joints.

Heavy work is the third phase of motor control and involves proximal movement with distal stability.

Co-contraction is the second phase of motor control and involves stability only, which is achieved by contracting opposing muscle groups. An example is contraction of the biceps and triceps to maintain elbow positioning.

Reciprocal inhibition or innervation is the first phase and involves reflexive movement patterns.

31.

What interventions are beneficial for those who present to therapy with pain?

Select the three BEST responses.

  • Physical agent modalities

  • Training on proper body mechanics

  • Gentle range of motion

  • Passive range of motion

  • Strengthening activities

  • Work performance

AROM, body mechanics, and PAMs are good interventions for most patients who experience pain. While certain PAMs may be contraindicated for some patients with other medical concerns, therapists can adjust the modality to suit the patient's needs. 

Passive range of motion is not always indicated, unless the patient has very little motion. Not all patients, especially those with severe pain, can tolerate strengthening activities as part of treatment. Work performance might be an area that therapists address when evaluating how a patient's pain impacts their life, but it doesn't describe a treatment.

32.

Before making any assistive technology recommendations, what should a COTA FIRST know about their patient?

  • Cognitive abilities

  • Patient's exact date of birth

  • Contexts where they plan to purchase the device

  • If they want to use more than one device at a time

Correct answer: Cognitive abilities

While therapists should assess many aspects during an assistive technology evaluation, a patient's cognitive abilities are one of the most important skills they should know about. If a patient has cognitive limitations, this will not only impact the type of device they can use, but those deficits will also influence the device training process.

A therapist should make age-appropriate assistive technology recommendations, but the provider does not need to know a patient's exact date of birth before offering intervention. A therapist should know what contexts the patient plans to use their device in and when this will take place, but therapists do not need to know where they plan to purchase the device. Regardless, purchasing is often taken care of by insurance companies, care coordinators, and other related parties. Therapists do not need to ask if patients want to use more than one device, as they should focus on trialing one or two devices and selecting the best fit from there. Providers should aim to recommend a device that comprehensively meets the patient's needs.

33.

AOTA states that occupations are "various life activities in which people, populations, or organizations engage." The occupational therapy team works to improve patient independence and function in many occupational areas. 

Which of the following occupations is an instrumental activity of daily living (IADL)?

  • Managing medications

  • Going to work

  • Showering

  • Getting dressed

Correct answer: Managing medications

Medication management is a higher-level personal care task that is considered an IADL. 

Going to work is an example of an employment-related occupation. Showering and getting dressed are basic activities of daily living (BADLs), which are self-care tasks an individual needs to perform on a daily basis.

34.

Which of the following are sequential phases of motor control according to the Rood approach?

Select the three BEST responses.

  • Heavy work

  • Cocontraction

  • Reciprocal inhibition

  • Transferrable learning

  • Generalization

  • Muscle synergies

The four sequential phases of motor control according to Rood are: reciprocal inhibition (also known as innervation), cocontraction, heavy work, and skill. 

Transferrable learning is a basic concept used in other theories. Generalization is used in motor learning to encourage the transfer of skills once a patient has made a certain amount of progress. Muscle synergies are a concept used in Rood, but they are not one of the phases.

35.

Once service competency has been established, what part of an orthopedic evaluation can an OTA assist with?

Select the three BEST responses.

  • Measuring edema using a volumeter

  • Measuring AROM using a goniometer

  • Using a dynamometer to measure grip strength

  • Administering the FIM

  • Administering the Barthel

  • Measuring a patient for an orthosis

Once an OTR has determined they are competent in these areas, it is within an OTA's scope of practice to measure edema, measure AROM, and take a patient's grip strength. 

OTAs cannot complete standardized assessments, so using the Functional Independence Measure (FIM) and Barthel are not appropriate. OTAs also cannot fit patients for orthoses, since this is part of an OTR's scope of practice.

36.

What is considered an intrinsic factor of falls?

  • Vestibular concerns

  • Medication side effects

  • Poor lighting

Correct answer: Vestibular concerns

Vestibular impairments such as vertigo and postural sway are medical concerns, which are all considered an intrinsic risk factor for falling since it cannot be modified. 

Medication side effects are an extrinsic risk factor since they can be changed through adjustments and new prescriptions. Poor lighting is another extrinsic risk factor, since lighting can be adjusted to prevent someone's risk of falling.

37.

Why might a patient need stand-by assistance to complete a certain task?

Select the three BEST responses.

  • The activity was recently modified by the therapist.

  • The patient needs some help for errors.

  • The patient needs some safety reminders.

  • The patient needs added time.

  • The patient needs physical assistance, but not cognitive assistance.

  • The patient does not need any help, but the therapist is nervous.

Stand-by assistance is warranted if the activity was recently changed, if the patient cannot recognize their own errors and needs therapist help for that, and if they need safety reminders. 

If a patient needed added time, they would be considered modified independent. If the patient needs physical assistance only, they would not be stand-by assistance since that is a "no contact" assist level. If the patient does not need any help, they would be labeled modified independent or independent, regardless of the therapist's feelings.

38.

Which two muscles of the rotator cuff are involved in external rotation of the shoulder?

  • Infraspinatus and teres minor

  • Supraspinatus and teres minor

  • Supraspinatus and subscapularis

  • Subscapularis and infraspinatus

Correct answer: Infraspinatus and teres minor

Both the infraspinatus and the teres minor control external rotation of the shoulder.

Subscapularis controls internal rotation, while supraspinatus controls abduction and flexion.

39.

During intervention for cardiac rehab, an OTA monitors the patient's pulse using the most common method/site. What palpation site is being used?

  • Radial 

  • Carotid 

  • Temporal

  • Brachial

Correct answer: Radial

A radial pulse is used most frequently to assess heart rate and is palpated on the radial side of the wrist, below the thumb.

A temporal pulse is palpated on the face, between the ear and eye. A carotid pulse is palpated via the carotid arteries in the front of the neck. A brachial pulse is palpated via the brachial artery above the anterior elbow.

40.

According to theories of group dynamics, what is NOT a stage of group development?

  • The healing phase

  • The origin phase

  • The conflict phase

  • The cohesion phase

Correct answer: The healing phase

The healing phase is not part of group development. Other stages of group development are the orientation phase, the intermediate phase, the maturation phase, and the termination phase.

The origin phase is first, and also when the group leader puts the group protocol together and plans group details such as size, location, and characteristics. The conflict phase is the fourth step of group development, and this is when members collectively challenge the structure, purpose, and processes of the group. It is common for members to experience disagreements during this phase, but it's crucial that they resolve this before the end of the phase, or this tension could jeopardize the future of the group. The cohesion phase is the fifth step of group development. This is when members regroup after a period of tension and have a renewed sense of purpose, along with greater group stability.

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